Is phosphodiesterase type 5 inhibitor use associated with condom breakage?

This is an open access article - Copyright © 2009 by the BMJ Publishing Group Ltd. All rights reserved.We tested the hypothesis that phosphodiesterase type 5 inhibitor (PDE5i) use would be associated with increased likelihood of condom breakage using an event-specific analysis. A convenience sample of 440 men completed an internetbased questionnaire that assessed variables pertaining to the last time they used condoms for penile-vaginal intercourse (PVI). A bivariate (screening) analysis was performed to identify covariates for a multivariate analysis using logistic regression. Altogether, 5.9% of the men reported breakage and 9.5% reported PDE5i use during the last time a condom was used for PVI. Among men who had used PDE5i during the last condom-protected occasion of PVI, 11.9% reported breakage compared with 5.3% of those not reporting PDE5i use. Adjusting for men’s age, ethnic minority status, marital status, reported duration of PVI and alcohol use at last PVI, those using PDE5i were about four times more likely to also report condom breakage (AOR 4.02; 95% CI 1.20 to 13.48; p=0.04). Of note, duration of PVI was independently associated with breakage (AOR 1.36; CI 1.02 to 1.83; p=0.04). Findings suggest that PDE5i use may potentially be associated with increased odds of condom breakage among some men.Support for this project was provided, in part, by the Rural Center for AIDS/ STD Prevention, a joint project of Indiana University, University of Colorado and the University of Kentucky, and by The Kinsey Institute, Indiana University

Turning on and turning off: A focus group study of the factors that affect women's sexual arousal

This is a post print version of the article. The official published version can be accessed from the link below.The aim of this study was to inform the development of a questionnaire to assess a woman's tendency to respond with sexual excitation/inhibition in different situations. Nine focus groups, involving 80 women (M age = 34.3 years; range, 18-84), were conducted. Women described a wide range of physical (genital and nongenital), cognitive/emotional, and behavioral cues to arousal. The relationship between sexual interest (desire) and sexual arousal was complex; sexual interest was reported as sometimes preceding arousal, but at other times following it. Many women did not clearly differentiate between arousal and interest. Qualitative data on the factors that women perceived as enhancers and inhibitors of sexual arousal are presented, with a focus on the following themes: feelings about one's body; concern about reputation; unwanted pregnancy/ contraception; feeling desired versus feeling used by a partner; feeling accepted by a partner; style of approach/initiation; and negative mood. The findings can help inform conceptualizations of sexual arousal in women.This research was funded (in part) by a grant from the Lilly Centre for Women‟s Health

Two heads are better than one: The association between condom decision-making and condom use errors and problems

This is an open access article - Copyright @ 2008 BMJ Publishing GroupObjectives: This exploratory study compared the frequency of condom use errors and problems between men reporting that condom use for penile–vaginal sex was a mutual decision compared with men making the decision unilaterally. Methods: Nearly 2000 people completed a web-based questionnaire. A sub-sample of 660 men reporting that they last used a condom for penile–vaginal sex (within the past three months) was analysed. Nine condom use errors/problems were assessed. Multivariate analyses controlled for men’s age, marital status, and level of experience using condoms. Results: Men’s unilateral decision-making was associated with increased odds of removing condoms before sex ended (adjusted odds ratio (AOR) 2.51, p=0.002), breakage (AOR 3.90, p=0.037), and slippage during withdrawal (AOR 2.04, p=0.019). Men’s self-reported level of experience using condoms was significantly associated with seven out of nine errors/problems, with those indicating less experience consistently reporting more errors/problems. Conclusions: Findings suggest that female involvement in the decision to use condoms for penile–vaginal sex may be partly protective against some condom errors/problems. Men’s self-reported level of experience using condoms may be a useful indicator of the need for education designed to promote the correct use of condoms. Education programmes may benefit men by urging them to involve their female partner in condom use decisions.Funding for this project was provided by the Canada Research Chair in Social Justice and Sexual Health at the University of Windsor, and the Rural Center for AIDS/STD Prevention and The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University

Does it fit okay? Problems with condom use as a function of self-reported poor fit

This is an open access article - Copyright © 2010 by the BMJ Publishing Group Ltd. All rights reservedOBJECTIVE: To identify associations between men's self-reports of ill-fitting condoms and selected condom use problems, using an event-specific analysis. METHODS: A convenience sample of men was recruited via advertisements in newspapers (two urban and one small town) and a blog on the website of a condom sales company. Men completed a questionnaire posted on the website of The Kinsey Institute for Research in Sex, Gender, and Reproduction. Inclusion criteria were: at least 18 years old, used condoms for penile–vaginal intercourse in the past 3 months and the ability to read English. RESULTS: In controlled, event-specific, analyses of 436 men, those reporting ill-fitting condoms (44.7%) were significantly more likely to report breakage (adjusted odds ratio (AOR 2.6), slippage (AOR 2.7), difficulty reaching orgasm, both for their female partners (AOR 1.9) and for themselves (AOR 2.3). In addition, they were more likely to report irritation of the penis (AOR 5.0) and reduced sexual pleasure, both for their female partner (AOR 1.6) and for themselves (AOR 2.4). Furthermore, they were more likely to report that condoms interfered with erection (AOR 2.0), caused erection loss (AOR 2.3), or became dry during sex (AOR 1.9). Finally, they were more likely to report removing condoms before penile–vaginal sex ended (AOR 2.0). CONCLUSIONS: Men and their female sex partners may benefit from public health efforts designed to promote the improved fit of condoms.Support for this project was provided, in part, by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, University of Colorado, and the University of Kentucky and by The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University

If the condom fits, wear it: a qualitative study of young African-American men

This is an open access article - Copyright @ 2004 BMJ Publishing GroupObjective: To extend the current knowledge base pertaining to condom failure among young African-American men by assessing their experiences with male condom use. Methods: Qualitative assessments were conducted with 19 African-American men (aged 18–29 years) who had just been diagnosed with an STI and reported using condoms in the previous 3 months. Results: Five categories were identified from the data. These categories pertained to: (1) the “fit and feel” of condoms; (2) condom brand and size; (3) application problems; (4) availability of condoms and lubricants; and (5) commitment to condom use. Common themes included reasons why men believed condoms would break or slip off during sex. Comfort problems, including tightly fitting condoms and condoms drying out during intercourse, were mentioned frequently. Condom associated erection problems were often described. Many men also noted that condom use reduced the level of sexual satisfaction for their female partners. Men noted that finding the right kind of condom was not always easy and it became apparent during the interviews that men typically did not acquire lubrication to add to condoms. Despite their expressed problems with using condoms, men were, none the less, typically emphatic that condom use is an important part of their protective behaviour against STIs. Conclusion: Men were highly motivated to use condoms; however, they experienced a broad range of problems with condom use. With the exception of losing the sensation of skin to skin contact, the vast majority of these problems may be amenable to behavioural interventions.This study was funded by a grant from the National Institutes of Mental Health (1 R21 MH066682-01A1)

Men with broken condoms: Who and why?

This is an open access article - Copyright @ 2007 BMJ Publishing GroupObjectives: To identify (1) the prevalence of condom breakage, and demographic and sexuality-related differences among young men who have sex with women reporting and not reporting this event; (2) condom-specific behaviours associated with breakage. Methods: Young men (n=278) attending a clinic for treatment of sexually transmitted infections (STIs) responded to an anonymous questionnaire aided by a CD recording of the questions. The samples were screened to include only men who had used a condom during penile–vaginal sex at least three times in the past 3 months. Condom-specific behaviours (including breakage) were assessed using these last three acts of condom use as the recall period. Correlates achieving bivariate significance were subjected to multivariate analysis. Results: Nearly one third (31.3%) of the men reported recent breakage. The breakage rate was 15%. Three correlates significantly distinguished between men who did and did not report breakage. Men who had past STIs were more likely to report breakage (adjusted odds ratio (AOR) 2.08), as were men who also reported condom slippage (AOR 2.72). Less self-efficacy for correct condom use was also significantly associated with breakage (AOR 1.07). Further, three condom-specific behaviours were significantly associated with breakage: allowing condoms to contact sharp objects (AOR 2.6), experiencing problems with the “fit or feel” of condoms (AOR 2.3) and not squeezing air from the receptacle tip (AOR 2.0). Conclusions: Breakage may be common and may occur in a larger context of difficulties with condoms. STI clinics could potentially benefit some men by providing instructions on the correct use of condoms.Financial Support for this project was provided by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, University of Colorado and University of Kentucky, and the Office of the Associate Dean of Research, School of Health, Physical Education, and Recreation, Indiana University

Do sound waves transport the AGN energy in the Perseus cluster?

The level of random motions in the intracluster gas lying between 20 and 60 kpc radius in the core of the Perseus cluster has been measured by the Hitomi Soft X-ray Spectrometer (SXS) at 164 ± 10 km s$^{−1}$ . The maximum energy density in turbulent motions on that scale is therefore low. If dissipated as heat, the turbulent energy will be radiated away in less than 80 Myr and cannot spread across the core. A higher velocity is needed to prevent a cooling collapse. Gravity waves are shown to travel too slowly in a radial direction. Here we investigate propagation of energy by sound waves. The energy travels at ~1000 km s$^{−1}$ and can cross the core in a cooling time. We show that the displacement velocity amplitude of the gas required to carry the power is consistent with the Hitomi result and that the inferred density and temperature variations are consistent with $\textit{Chandra}$ observations.ACF, CP, CSR and HRR thank the Hitomi collaboration for the opportunity to participate in the analysis of the SXS data. ACF, CP, HRR and SAW acknowledge support from ERC Advanced Grant FEEDBACK, 340442

Predictors of failed attendances in a multi-specialty outpatient centre using electronic databases.

BACKGROUND: Failure to keep outpatient medical appointments results in inefficiencies and costs. The objective of this study is to show the factors in an existing electronic database that affect failed appointments and to develop a predictive probability model to increase the effectiveness of interventions. METHODS: A retrospective study was conducted on outpatient clinic attendances at Tan Tock Seng Hospital, Singapore from 2000 to 2004. 22864 patients were randomly sampled for analysis. The outcome measure was failed outpatient appointments according to each patient's latest appointment. RESULTS: Failures comprised of 21% of all appointments and 39% when using the patients' latest appointment. Using odds ratios from the mutliple logistic regression analysis, age group (0.75 to 0.84 for groups above 40 years compared to below 20 years), race (1.48 for Malays, 1.61 for Indians compared to Chinese), days from scheduling to appointment (2.38 for more than 21 days compared to less than 7 days), previous failed appointments (1.79 for more than 60% failures and 4.38 for no previous appointments, compared with less than 20% failures), provision of cell phone number (0.10 for providing numbers compared to otherwise) and distance from hospital (1.14 for more than 14 km compared to less than 6 km) were significantly associated with failed appointments. The predicted probability model's diagnostic accuracy to predict failures is more than 80%. CONCLUSION: A few key variables have shown to adequately account for and predict failed appointments using existing electronic databases. These can be used to develop integrative technological solutions in the outpatient clinic

Spin Seebeck insulator

Thermoelectric generation is an essential function of future energy-saving technologies. However, this generation has been an exclusive feature of electric conductors, a situation which inflicts a heavy toll on its application; a conduction electron often becomes a nuisance in thermal design of devices. Here we report electric-voltage generation from heat flowing in an insulator. We reveal that, despite the absence of conduction electrons, a magnetic insulator LaY2Fe5O12 converts a heat flow into spin voltage. Attached Pt films transform this spin voltage into electric voltage by the inverse spin Hall effect. The experimental results require us to introduce thermally activated interface spin exchange between LaY2Fe5O12 and Pt. Our findings extend the range of potential materials for thermoelectric applications and provide a crucial piece of information for understanding the physics of the spin Seebeck effect.Comment: 19 pages, 5 figures (including supplementary information

Graded structure in sexual definitions: categorizations of having “had sex” and virginity loss among homosexual and heterosexual men and women

Definitions of sexual behavior display a robust hierarchy of agreement regarding whether or not acts should be classed as, for example, sex or virginity loss. The current research offers a theoretical explanation for this hierarchy, proposing that sexual definitions display graded categorical structure, arising from goodness of membership judgments. Moderation of this graded structure is also predicted, with the focus here on how sexual orientation identity affects sexual definitions. A total of 300 18- to 30-year-old participants completed an online survey, rating 18 behaviors for how far each constitutes having “had sex” and virginity loss. Participants fell into one of four groups: heterosexual male or female, gay male or lesbian. The predicted ratings hierarchy emerged, in which bidirectional genital acts were rated significantly higher than unidirectional or nonpenetrative contact, which was in turn rated significantly higher than acts involving no genital contact. Moderation of graded structure was also in line with predictions. Compared to the other groups, the lesbian group significantly upgraded ratings of genital contact that was either unidirectional or nonpenetrative. There was also evidence of upgrading by the gay male sample of anal intercourse ratings. These effects are theorized to reflect group-level variation in experience, contextual perspective, and identity-management. The implications of the findings in relation to previous research are discussed. It is suggested that a graded structure approach can greatly benefit future research into sexual definitions, by permitting variable definitions to be predicted and explained, rather than merely identified